If you suffer from eczema then you know what a struggle it can be to find the right topical support for relief. I say “support” instead of “remedy” because when we’re treating our skin topically, it’s going to be supportive rather than curative, which remedy implies.

So, where do you even begin??

With the enormous amount of treatments out there, it can be daunting to find the one that’s right for you. You almost have to treat it like a process of elimination to see what works with your particular brand of eczema.

For the most part, I’m a middle of the road person when it comes to medications, natural remedies, and OTC’s. I don’t believe there’s one best way or best system. If you’ve got asthma, you’re probably going to need an inhaler until you actually get the underlying inflammatory process under control.

There’s nothing worse than when you’re in the middle of an eczema flare. Your skin is an itchy oozy mess, you feel horrible, and all you need is something to help calm it down.

So let’s talk about what you can put on your skin to help tame the flame and itch!

Prescription Medications

Steroids.Topical steroids are very common when it comes to treating an eczema flare. They work by reducing inflammation which calms the itch and gives your skin a chance to heal. Like over-the-counter (OTC) cortisone, prescription steroids work similarly to the anti-inflammatory hormone cortisol made in your body, but they’re much stronger.

As a general rule of thumb, it’s best to start with a lower potency in short bursts and then stop once the flare settles.

While I think steroids can be helpful in the short-term, I’m not in favor of long-term use. They can have detrimental effects such as thinning of the skin, acne or stretch marks. It basically decreases the integrity of the skin which is the exact opposite of what we’re trying to achieve when treating with eczema.

In some rare cases, steroids can induce other skin conditions like rosacea. The last thing we want to do is add another inflammatory skin issue to the one we’re already dealing with.

In addition to these side effects, there’s also a skin condition associated with excessive topical steroid use called Topical Steroid Withdrawal (TSW). The symptoms are actually similar to eczema– dry, itchy, red, burning skin in mild cases and oozing, bleeding skin in the its more severe form.

Eucrisa. Similar to steroids, Eucrisa alters the body’s natural inflammatory process that triggers eczema symptoms. The main ingredient, crisaborole, is combined with an emollient-rich ointment that helps keep the skin moisturized.

But like most prescription medications, you run into possible side effects. The more common ones include burning or stinging when the medicine is applied.

Here’s the thing with prescription medications– they’re often designed to shut down biochemical pathways by blocking enzymes, so they basically turn off your natural processes. This alters your biochemistry causing shifts in the inflammatory processes and the immune system.

In the case of Eucrisa, it blocks the enzyme PDE4 (phosphodiesterase-4) which shuts off certain inflammatory signals, effectively decreasing or stopping the process.

The goal is to give the skin more support and heal it, rather than shut off biochemical pathways. Not to mentioned the many underlying causes that aren’t addressed when the inflammatory process (read: body’s danger signal) is artificially blocked.

Like I said, I’m a middle-of-the-roader when it comes to prescription topicals. I think they have their place, but not when it comes to finding a long-term solution. It’s important to get to the root cause of why you have certain things going on in your body.

OTC Medications

Most practitioners can’t speak with insider knowledge of the over-the-counter lotions and potions- but I can because one of my first jobs out of undergrad was in the formulation department for a very well-known personal care and paper products company (yes, it was a long and winding road for me to get here!!).

My job was on the microbiology and chemistry side, so I got to experience firsthand what types of chemicals were used and the effects they can have. This was one of the many things that actually drove me to wanting to go more natural!

Even though I’ve seen the negative side of OTC’s, I do think they have their place when it comes to finding immediate relief.

Hydrocortisone cream. Cortisone creams relieve eczema bouts the same way most prescription topicals do. Synthetic cortisone mimics the actions of cortisol, your main anti-inflammatory hormone, but is more pronounced. It works by suppressing the inflammatory signals that get triggered and block the symptoms caused by inflammation.

Helpful in the short term? Possibly, yes.

Long term solution? NO.

Benadryl cream.Antihistamines such as Benadryl (diphenhydramine) cream are very common when it comes to soothing the itch that comes with eczema. They’re generally used to treat allergies by blocking the effects of histamine– an immune system protein and signaling chemical. The body can mistake things like pollen as a harmful substance in the body and then releases histamine to fight it off. This is what causes the itchy eyes and runny nose. Even though eczema isn’t an allergy, antihistamines do have a sedating and anti-inflammatory response that helps relieve itching.

The downside to OTC medications is that they just work as a band-aid instead of solving the actual problem. They’re very accessible and inexpensive so it’s easy to become reliant on them rather than find a solution to the root cause.

Conventional Topicals

Eucerin. This is a well known brand that creates creams and lotions specifically for dry skin and eczema. Eucerin contains emollients which promote moisture and increases the skin’s capacity to hold onto water. Keeping the skin moisturized can provide some itching relief and give it a chance to heal.

Cetaphil. Cetaphil is another brand that has a line of lotions made primarily to help treat eczema. Their eczema specific moisturizer has an active ingredient called filaggrin which is an essential protein for skin hydration and barrier function. Many people with eczema have mutations in the filaggrin gene which is why they are prone to eczema, rashes and general skin irritation.

Petroleum jelly/Vaseline.Petroleum jelly is a topical that dermatologists recommend frequently because people with sensitive skin can generally tolerate it. It locks in moisture and protects against outside allergens. It’s a highly process petrochemical that many sensitive people react to, not to mention the environmental impact.

Most conventional topicals are going to provide some support and dampening of the inflammatory feeling on the skin. The downside is that most of them contain synthetic ingredients like sodium dodecyl sulfate (SLS), isopropyl palmitate, parabens, and preservatives to name a few. These chemicals are known toxins or irritants so it’s important to remember that anything you put on the skin will get absorbed into the body.

Some of these chemicals are also endocrine disruptors which is something you don’t want to mess with. They are stored in fat cells and alter normal hormone biochemistry, especially estrogens and estrogen hormone pathways.

Natural Topicals

The last area I wanted to touch on are the natural remedies. And as always, you have to find what works for you.

I’ve tried so many over the years I’ve lost count. We hear the same thing from our patients as well.

I always kid around when we have the, “what have you tried?” conversation because most of us have a lotions and potions graveyard. You know… the drawer where all of your partially used topicals go to die!!

Herbal Treatments. Moon Valley Organics has EczaCalm and Herbal Heal. I use both of these depending upon my needs. I’ve been using Herbal Heal over EczaCalm because lately I feel like that’s been working really well for me. Both of these have about 12 different ingredients made with organic carrier and essential oils, as well as many herbs that are anti-inflammatory.

They both contain calendula which is known in the herbal world to be very nourishing to the skin. It’s a pretty awesome ingredient because there are no known side effects, it’s incredibly healing, and it can be used across all age ranges. You’ll see it in some of the more natural baby diaper creams— Bottom Balms, for example. It really can be used in a wide array of applications.

The beauty of using EO’s is that they have multiple avenues of how they’re helping. Some of the most common mechanisms of action are antimicrobial, anti-inflammatory, calming, analgesic (pain eliminating), and skin supporting. You’re going to get a little more bang for your buck with the cross-functional types of support they provide.

Frankincense, also known as boswellia, is my FAVORITE! It’s a potent anti-inflammatory that has lots of research behind it. It’s also a great immune booster, stress reducer, and healing to the skin. It’s steroid-like structure is thought to be one of the reasons it’s so effective. I use it topically, aerosolized in a diffuser, and internally for treating all types of inflammatory conditions, not just eczema. Frankincense is literally the Swiss Army knife of the anti-inflammatory world!

Lavender is calming, sedating, and has some inflammation relieving properties. It’s also well tolerated by most people, including children and babies. A little at bath time (for kids and adults) helps soothe the skin and the mind.

Myrrh is another cross-functional heavy hitter like Frankincense. It has all of the “anti’s”… antioxidant, anti-inflammatory, and antimicrobial to bacteria, parasites, and fungi (like Candida). A bonus is that it has anti-cancer properties as well. Historically it has been used to heal wounds and cracked/chapped skin.

Tea tree oil, like Frankincense and Myrrh, has many beneficial properties, but it’s broad spectrum antimicrobial actions are what make it famous. It’s active against a wide array of microorganisms (bacteria, yeast, other fungi, parasites, and viruses) making it a very useful tool. Staphylococcus aureus and yeast based infections such as Candida, jock itch or ringworm (yes, it’s a fungus- not a worm) are sometimes implicated in eczema, and research shows tea tree oil to be effective against them.

Please note that sometimes, especially when used in excess, essential oils can be irritating to the skin. I always tell people to be very careful when they’re first starting to work with them. If you’re making a batch of something yourself or adding them to a bath, start off with just a couple of drops to see how your skin responds.

Organic Healing Balm. Dr. Bronner’s has an Baby Unscented Organic Magic Balm. I use this on my kids for everything. I sometimes use it on my eczema- it just depends on the severity of the itch.

A lot of people with eczema like Bronner’s, but some people find it a little bit irritating. I’d say stay away from the peppermint one and stick with the unscented balm.

All Good’s Goop is another good option. It has lots of herbs, olive oil, and coconut oil to soothe the skin.

Cleansing Oil. Another company that I really like is FatCo. I use their products myself and have heard from a lot of my clients that they love their facial cleansing oil. I’m an advocate of using oils because they don’t strip the skin like detergents found in other products.

They also have this myrrhaculous face cream. It has myrrh and tallow which are the main components in their lotions and creams. It’s highly supportive and nutritive to the skin. Speaking subjectively from my own experience (and the experience of a lot of the people that I work with that have used this), it’s just really supporting and nourishing to the skin.

Sea Salt Spray. This is something you can easily make yourself with some water and some sea salt at home. A lot of people who have eczema benefit from going into the ocean and salt water. Dead sea salt works really well because it’s packed with minerals that help balance the pH in your skin.

Kamedis. Kamedis has a complete eczema line from washes to lotions. I learned about this from patients that raved about it. They have created plant-based treatments for eczema that combine botanical extracts with OTC ingredients.

Theramu. Theramu is another one of my favorites. They’re also all-natural and use a combination of CBD and emu oil which provides bioavailability so it works where your skin needs it most. Both the CBD oil and emu oil are soothing so it’s one of the go-to’s in our clinic as a first line therapy to try out.

Summary

With a condition that is so highly individualized, you have to play around and find what works for you. Some topicals will work better than others and some will work for a short period of time.

While that can be frustrating, the great news is that true healing can be accomplished and you can banish the topicals forever!

The goal is to always get to the root cause of what’s going on, but if you’re in a really bad state, topicals can be the way to go to find immediate relief. And that’s okay! You can always transition and switch off of them as you work on your underlying causes.

Finding Relief From The Outside-In

If you’ve ever suffered from an eczema flare, then you’re probably familiar with the burning, itching, crawling sensation on your skin. And, you know how horrible it is!!

Your immediate instinct is to calm what’s happening on the outside… you just want to stop the scratching and bleeding and oozing.

In functional medicine, the goal is always to address the root causes and heal from the inside-out.

But when it comes to eczema… I know you need to have some relief on the outside first so that you can focus on the actual underlying causes— not just the symptoms.

What I’ve seen with skin issues, especially eczema, is that there’s no one-size-fits-all remedy.

Something that really irks me is when you go to message boards and people are like, “Oh, (insert favorite remedy) is my miracle cure….” or “I use dead sea salt baths” or “I use coconut oil” or “I use apple cider vinegar.” Don’t get me wrong, these things are all helpful, but everybody is so highly individualized that it’s hard to say any one thing will work across the board.

Eczema is more specific to the individual than any other condition we treat in our clinic, so we encourage people not to get caught up in other people’s hype. Do the work to heal inside, but in the meantime you can find ways to help soothe the rash.

9 Healing Bath Options

Something I’ve used myself, and have gotten back feedback from patients and colleagues alike is on the benefit of a healing bath. There are lots of different things you can put into a bath, but these are my top 9:

Magnesium sulfate/Epsom salt. These minerals can be very soothing for an eczema flare for a couple of reasons. Epsom salt helps decrease inflammation which can reduce the swelling of lesions and calm itching. It also has antimicrobial properties keeping your skin free of bacteria.

Dead Sea Salts. I’ve gotten a lot of positive feedback about this one which is in the mineral category. Dead Sea Salts aid in hydrating dry skin and can provide some itching relief with it’s anti-inflammatory properties. And more than Epsom salt, it’s packed with lots of minerals that help balance pH.

I like to add dead sea salts with baking soda or Epsom salt with baking soda to my bath— usually a cup of each if the itch is bad. You can buy them at any natural food store or on Amazon.

Borax/Boron. You might be familiar with Borax (sodium tetraborate) as a cleaning agent, but it can also be very soothing for an eczema flare. It helps lower inflammation and can be used to treat infection.

You’re probably starting to see a pattern that most of these have an anti-inflammatory response which helps decrease itching (but it’s all about finding out which ones work best for YOU).

Read here for further information on the many benefits of Borax, because like many of these remedies you can use it for many application.

Essential Oils. Essential oils (EOs) have a variety of healing benefits, but you have to be very careful because for some people they can incite more of a flare. Even if they’re used in small, diluted quantities in the bath, they still can be a little caustic to the skin.

I tell people to use them very sparingly if you’re going to use them. Tea tree oil or lavender oil are the two that I tend to use most frequently and recommend starting out with.

Of all the EOs, tea tree oil is one of the best for treating eczema symptoms. It has antibacterial components that help fight infection and stop it from spreading. It also has antifungal and anti-inflammatory properties that reduce itching.

Lavender oil can be calming for both your mental and physical state. It helps restore and balance healthy nutrients in the skin which reduces irritation. Bonus- lavender also minimizes the stress that goes along with an eczema flare.

Sitz Baths, Herbal Blends, and Chamomile Tea bags. If you’ve ever given birth, sitz baths are commonly recommended for their healing properties. I used them after both of my births and they significantly helped with the soothing and healing my skin.

I had an “A-ha” moment with my second baby last year because I’d had an eczema flare because of the hormones during pregnancy. I thought to myself, “Hey, I can probably use this for the eczema too,” so I tried it.

I actually bought Earth Mama Angel Baby (which just recently changed its name just to Earth Mama) since they make pre-made sitz bath pouches. I bought those because, quite frankly, who has the time to make them when you’ve got a new baby or kids or just have a busy life?

I also augmented it with dried chamomile that I got from a natural food store that I put that in cheesecloth or a sock if you don’t have cheesecloth. Soaking with those for about 20 minutes really soothes my skin (and my mind). Chamomile tea bags also work instead of preparing the dried herbs.

Bonus tip— sitz herbs are also recommended for hemorrhoids and diaper rash!

Colloidal Oats. I put a big asterisk by this one because of the *gluten issue*, but some of my patients have experienced healing benefits from colloidal oats or oatmeal so I didn’t want to exclude it.

Many people with skin and gut issues tend to have problems with gluten internally and sometimes externally. Those with Celiac can get a skin manifestation called dermatitis herpetiformis. I’ve seen people who have not been diagnosed with Celiac, but do have the dermatitis herpetiformis and it’s misdiagnosed as eczema.

Now, the cool thing is, really, it doesn’t matter what you label something on the skin. You’re going to end up treating it essentially the same especially because these are all in the autoimmune realm.

Like I said, I’m really careful when it comes to recommending anything that is grain-based, but this is where bio individuality comes into play. One person’s poison can be another’s medicine. If you’re going to do this, make sure it’s gluten-free. If gluten is an issue for you, and you don’t know it yet, you want to make sure you’re not adding fuel to the fire.

Hydrogen Peroxide. Most of us have this under our bathroom sink to clean out cuts or as a natural cleaner. When added to a bath, it helps disinfect eczema sores and promotes new cell growth.

Be sure to use a food grade hydrogen peroxide and add no more than one cup to your bath. I recommend starting off a little slower with maybe ½ cup to see how you tolerate it.

Baking Soda. This is another household item that has many uses. I buy a giant bag at Costco because of the quantities I use and it’s way more economical. I add this to almost every bath for myself and kids even when I don’t have a flare because of its other benefits.

As I mentioned in #1, combined with Epsom salt it makes for a great detox bath.

Apple Cider Vinegar. Similar to the previous point, apple cider vinegar is also multifunctional. It has compounds like riboflavin, vitamins, enzymes, and mineral salts which can improve the quality of your skin.

It acts as an astringent and helps remove surface bacteria that shows up when the skin is compromised from a flare.

Experiment with the quantities that work for you, but I would start by adding ½ – 1 cup to your bath.

Bottom Line

Many of these are items you likely already have in your home for other reasons, or you’ve built yourself a “natural medicine cabinet.” Start with one ingredient at a time. Go slowly by using ¼- ½ cup with of the powdered ingredients or single drops of essential oils initially, then work up to the full dose you need from there.

If something completely doesn’t work for you, try something else from the list. Remember that it may take some time to see what works for you and dial in your recipe. You can always tweak it once you see what works for you.

Most people will get some type of relief from something on the list, even if it’s only a small amount.

Resist the urge to go hog wild with any of the ingredients because you could end up stoking the flames and adding fuel to the fire. It’s so easy to go overboard when you finally find a remedy that provides some relief. But heed my words… don’t do it!! (I know from personal experience and it was a disaster!)

There’s no one blanket approach to calm an eczema flare which is why I like to suggest a variety of options. All of these are going to provide different healing properties. Some are going to balance the pH while others will have antimicrobial effects, but they’re all going to be anti-inflammatory to some extent.

Have you experimented with any of these healing baths? Let us know in the comments section!

There is one thing that eczema, infertility, and miscarriages have in common…

All three can make you feel very alone and very tortured physically and mentally. I’m sharing my story with you because I think it’s SUPER important to change attitudes on child loss AND, inform people about the link between inflammation, autoimmunity, and infertility.

Bear with me first though- some confessions.

First, you’ll note as you read through this that I started writing it in December. I started but couldn’t bring myself to finish it, let alone publish it. I was afraid and still broken.

Second, because of the inspiration of some of my superwoman friends and colleagues in the health space, I’ve been able to process my traumas and gather the courage to share this with you all. THANK YOU to Anna Cabeca, Brie Wieselman, Christine Faler, Jaime Ward, Jenn Fugo, Jessica Drummond, Jolene Brighten, Keesha Ewers, Sheri Fox, and Steph Gaudreau.

You ladies all inspire me. EVERY. SINGLE. DAY.

I have so much gratitude for having you all in my life. We don’t tell people often enough how much they matter to us, so I want to let you all know.

Third, there are some very raw and vulnerable moments, so you might cry reading it as I have writing and editing it.

My Story

Miscarriages SUCK and are still taboo in our culture. This is really unfortunate because those of us who have suffered in the dark know what a lonely, hellish place they can be. NO ONE should have to suffer in silence when they’re dying inside. And sadly, no one can really relate unless they’ve ever suffered the loss of a child. It leaves you with a hole inside that never goes away.

[Initial thoughts from December] I’m doing something I never do right now. I’m attempting to write this in the throes of many emotions. On one hand I’m extremely happy because my little sister just gave birth to a healthy baby boy. It’s a pretty exciting time for our family this year since I had my little girl almost 5 months ago.

On the other hand, I’m feeling very sad. Alone. Gnawing pain.

Because today is the anniversary of my first miscarriage. That was one of the hardest days of my entire life.

Worst day ever.

Looking back, it taught me many lessons about life, autoimmunity, and eczema. But that doesn’t make it hurt less.

On Christmas day two years ago I was trying to act like it was a normal day. I should have been extremely happy to watch my almost three year old open his presents and have family over. I was in the kitchen prepping Christmas dinner, but deep down inside I knew something was very wrong.

I was wearing a shirt that said “joy” and I couldn’t have felt further from that. I knew deep down that I was probably having a miscarriage. I went through the day thinking, “things like this happen… women have spotting and cramping and they still have healthy babies.” I was in complete denial.

I made it through dinner and went to bed, but I couldn’t sleep. I had a sense of impending doom that would not leave. And like many women, I tend to labor in the middle of the night. The cramps got worse and then my worst nightmare was realized. I was definitely having a miscarriage.

If you’re far enough along it proceeds exactly like a labor. I’ll spare you the details because it was HORRENDOUS as I’m sure you can imagine.

The experience is seared into my brain. I wish it was a foggy memory but I can’t forget. I remember sitting on the bathroom floor just sobbing and feeling so alone. My husband was there but I don’t think he knew what to do. I just sat there for what seemed like an eternity.

Eventually, I laid back in my bed next to my husband, but I felt like I was the only person in the world.

I couldn’t go to sleep so I went downstairs to our couch, laid in the fetal position and cried for 4 hours. Literally to the point I was nauseous and had no tears left.

The next several days were a blur.

I was largely catatonic. My sister was one of the few people I told and she came over and brought me flowers which I really appreciated but it still felt unbearable. I’ve had a few low moments in my life but I don’t think I’ve ever truly felt depressed.

I was quite depressed after this. I was numb. Thankfully, I had my son because if I didn’t I really don’t know what would have happened.

I got pregnant again in March and was cautiously optimistic. Things seemed to be progressing fine. I made it past the 8 week mark and was breathing a minor sigh of relief since that is when I had my first miscarriage. But then at 12.5 weeks, I had another one.

This one was different. Still agonizing, but I felt like I knew what to expect and went through the motions.

Almost like an out of body experience.

Again, I’ll spare you the details. And again, I really only told my sister and super close friends.

I suffered in silence.

I don’t want that for you.

It’s the worst feeling in the world.

And, it’s the opposite of what you should do.

For mamas that’ve experienced any loss, you know your world will never be the same. There will always be a hole in your heart for your little angel. As time goes on it hurts a little less but it will creep up on you when you least expect it and that empty, hollow feeling can return.

Mother’s Day will never be the same, even if you have children. The two Mother’s Days since I’ve had my miscarriages have been filled with both love and sadness. Last year when I was pregnant was particularly hard. I was sad and silently hoping that everything turned out fine because I didn’t know if I can handle another even more dramatic loss. I cried A LOT on Mother’s Day in a mix of hormones, fear, and grief.

Rainbow Baby

Thankfully, my story had a happy ending. My amazing and beautiful rainbow baby was born in August of 2018. She’s such an amazing little girl. She’s been so sweet and so happy from day one. People comment on how smiley and what a good demeanor she has.

I don’t take for granted how incredibly blessed and lucky I am because I know that there are women out there that won’t get that chance.

Women’s health, fertility, pregnancy, and birth are sacred. We need to support each other through the good and the bad. We need to make a long-term commitment to each other not just in the days and weeks after a birth or a loss, but in the months and years that follow. Because these moments become the fabric of Who We Are and intertwine us all together. They form the blanket of support that we need to give one another.

So, I want you to know, I am here for you.

And those ladies I thanked above- they’re in your corner too. They are all in the health and functional medicine space too- many are women’s health specialists- but all are darn awesome women.

A few of them (you know who you are) are probably why I was able to get pregnant and keep the baby to term.

Together, we ran a bunch of tests on me. My hormones were low across the board (thyroid, adrenals, estrogen, progesterone and testosterone. I had dysbiosis from stress and previous birth control pill use (that’s another long and horrible story).

The likely culprit for my losses began as STRESS. Long term stress. That stress depleted my hormones, damaged my gut, and caused food sensitivities, nutrient depletions, and my eczema.

You need progesterone to maintain your pregnancy and I couldn’t make enough. Had enough to get pregnant, but not enough to stay pregnant. This is a big problem for women today. We’re all depleted from the stress and abuse we put our body’s through.

So, I got to work.

The Fix

Since my hormones were a mess I got on compounded, bioidentical DHEA and progesterone. I also upped my dose of compounded T3/T4. I knew I needed to get my hormones going in the right direction quickly and this was the best way for me, especially since I’ve had reactions to other types of hormone support in the past.

I went on an AIP rotation diet to calm my system down and start to heal my gut. Then I did 8 weeks on a dysbiosis protocol for pseudomonas and staphylococcus (using herbal blends, monolaurin, and rotated probiotics) with liver support. I followed that up with 3 months of gut terrain rebuilding and immune support. I also did some work on resolving past traumas too.

In all, this process took me 8 months, but then….

I missed a period and found out I was pregnant even though I wasn’t actively trying.

Again, mixed emotions.

I was so happy, but so scared. I went through 75% of the pregnancy scared. Loss traumatizes you in ways you can’t imagine. I was super paranoid and had been before.

I took progesterone for the first 20 weeks of my pregnancy- 4 weeks longer than was recommended because I was that worried. It worked…and you know the rest of the story.

I had my beautiful rainbow baby.

But that doesn’t mean there aren’t scars and wounds that surface from time to time.

So, I need my tribe, which now includes you.

I’m here if you need me, because I want to help mamas be healthy, clear eczema, get rid of autoimmunity, and have healthy babies.

That is my mission.

And, we have to support each other. As women we need to have a voice and not stay in the dark.

It took me a couple of years to come out and share this, but I’m so happy I did. Because if I help even just one mama get through her dark time or resolve her root causes to have a healthy baby, I’ve accomplished my goal.

I hope you had a wonderful Mother’s Day 2018 no matter your circumstance. Earth babies and angel babies all count!! It’s okay to feel both happy and sad too. Don’t let anyone tell you otherwise.

If you know anyone that could use support, please share this with them. I really wish I had reached out for more help or someone gave me a little nudge to get more support. If they aren’t ready, just be there for them through the process and step up when called upon.

The topic of stress is tossed around so much these days that it seems we’ve become desensitized and brush it off. But the fact remains that stress is indeed one of the most notorious triggers for eczema and autoimmunity.

And, the holidays are often stressful times for most of us. On the surface, Easter seems pretty easy and benign, right??

Well, not really.

Granted, it isn’t the long, drawn-out process that Christmas has become now that the “holidays” start the day after Halloween (not to mention cost in money, time, and sanity). But, it definitely shares a few key components of the other major holidays that might cause an eczema flare.

Stress Related Triggers

Travel. Preparing for travel and the act itself are bigger stressors than you may think. It burdens your mind with all of the things you need to do before you leave, even if it’s only for a day or two. Packing and prep are hard enough, but add kids and pets and the stress is magnified (parents of kids and fur babies know what I’m talking about!!). Then there’s coming home to laundry, no food, and maybe even work since technology can be a ball-and-chain that way.

Family. It depends on your family dynamics and for many this isn’t so bad, but the larger the gathering, the bigger opportunity for issues to arise. Often family members feel free to let their opinions fly, disregard others’ feelings, or like to “stir the pot.” Every family has one (or more!). In my family we give out the Blueberry Muffin Award at the end of events for the person that causes the biggest problem. (I’ve only received it once- about 20 years ago when I was in college).

It can also be difficult if you make healthier (“different”) lifestyle choices, and this is very real possibility if you have eczema. For years I’ve been teased about my diet and lifestyle choices. I’ve learned to ignore them because I’m WAY healthier than the people teasing me. Usually when people give you a hard time it’s because they’re feeling insecure or inadequate about themselves. Psychologically, it makes them feel better to go after you because you’re doing something they can’t or won’t do. That doesn’t make it okay, but you can take the high road.

Gawkers. Perhaps one of the most difficult things to deal with when you have eczema is people staring. As if you’re not self-conscious enough!?!?! If it’s family or close friends, these are usually the same people who have some smart-ass comment too. Being in a public setting with strangers can be rough too because that’s like an open invitation to stare because of the mob mentality.

Don’t Let Stress Get You Down

Having a strategy going into the holidays is key to not succumbing to the stress monster and ending up with an eczema flare. Take some time to think of possible stressors you’ll encounter and figure out how you’ll handle them before they even happen. Here are some helpful tips :

Planning will help you take some of the stress out of travel. Make a list of what you need to bring and getting things ready during the week prior to your trip helps avoid chaos right before you leave. Gas your car up a day or two earlier if you’re driving (this usually saves time and money). Get healthy food ready for your journey and make sure it’s easily accessible. Even if your only traveling down the street, preparing food the day before will help things go smoothly.

Bring food if you have special dietary needs and there won’t be options for you to enjoy the occasion. Ask ahead what will be served and let them know your situation. Often people are accommodating and understanding, especially if you’ve been down the eczema road for a while. If they aren’t helpful, control your own destiny and bring your own food. Upsetting your host’s feelings is not your problem when you’re skin is on fire (or could flare back up).

Don’t let the emotional bullies and energy vampires ruin your holiday! If people tease you for your choices, make snarky comments, or stare too long, you’ve got options on handling this. 1- Laugh it off and know that they lash out at others from their own place of hurting or insecurity. 2- Ask them when they got their medical or health care education when they give you unsolicited advice (since their comments are almost always rooted in opinion). 3- Bring an awesome dish that follows your dietary needs or restrictions, but don’t tell anyone it’s any different until they taste it and love it. Prove to them that their misconceptions on diet are exactly that. There are soooo many gluten, dairy, soy, corn, histamine, or _______ (insert any food here) free recipes that rock, so show them!

Attitude is everything when dealing with stress. If you go into the event with a positive attitude, chances are things will go well. This is where self fulfilling prophecy comes into play.

Breathing can also help get you through rough times. On many occasions I have chosen to take a few deep breaths and move on instead of engaging someone that’s trying to make me feel bad. I try to remember that it’s a them issue and not a me issue. They are just projecting onto me. It still sucks and can hurt, but I consciously know it’s not me and that’s huge.

This point may be controversial, but when we’re talking stress and health it’s completely valid- skip the holiday events if you think they’ll be too much for you. If you’re in the middle of a horrible eczema flare or have had lots of stressors in your life recently, this may be the best option for you. If you know going to Easter brunch or dinner will be a battle and will put you in a worse place then politely decline. Tell everyone you’ll see them at the next event. You don’t owe anyone an explanation even though family often feels entitled to one. If you do say something tell them the truth and be authentic because that will serve you better.

Make the holidays enjoyable and as stress free as possible to avoid the Easter Bunny leaving eczema in your basket! If you have any tips or suggestions for stress free holidays, please share in the comments below.

Understanding an eczema outbreak is really complex. And like a child learning language, you have to understand the alphabet and sounds first before you can talk. Same goes for eczema.

To really understand an eczema outbreak, you have to first understand the difference between the way functional medicine and conventional medicine views it.

Why Functional Medicine?

Functional medicine (FM) is a “systems” way of thinking. And when we say “systems,” it’s not like conventional medicine that views the body as a group of isolated systems where you have a cardiologist for the heart, an endocrinologist for hormones, etc. In FM, we view the systems, or areas of the body, as operating as a whole response to the environment (kind of like the operating system of a computer).

It makes perfect sense because each area influences the others.

A good analogy to help you understand functional medicine versus conventional medicine is to think about a tree. Visualize the entire tree with its roots, trunk, branches, and leaves. Conventional medicine looks at one branch, whereas functional medicine views all of the branches, trunk, and roots. It’s going to look at the leaves and even further in-depth because we really want to understand what’s going on in the entire person.

When we do this, we take a really detailed history and look for root causes. It’s interesting that we look for root causes and use the tree analogy, because the goal is to find out what is foundationally disrupted in your body to figure out what’s causing the eczema flare.

Conventional medicine really tends to see eczema as something that doesn’t truly have a cause yet. When I was told that I had eczema the doctor said, “You’ve got eczema. There’s no known cure. See you later.” However, in functional medicine—and now even in the medical literature (check it out here)—they’re starting to talk about it as an autoimmune condition and starting to identify some causes of it. And that’s what we’re going to get into here a little bit later.

This is why taking a FM approach to looking at eczema really can help you get down to why things are happening.

The ATM Model

One of the foundational principles of understanding functional medicine is the concept of antecedents, triggers and mediators. We call it the ATM model. These are how a functional medicine practitioner frames an understanding of your entire life history and contributing factors to your condition. We’re looking at all of that to figure out how you got to where you are today.

Let’s start off with the antecedents, which are the predisposing factors. Those are things like genetics and family history, lifestyle, past illness, and exposures (occupational, home, or environmental), and are the underlying or precipitating cause of illness.

A key point regarding genetics and family history is that they aren’t life sentences. A lot of people think, “Oh, there’s cancer in my family. I’m going to get cancer.” That’s not necessarily the case. There are so many modifiable factors here that can prevent you from actually having that illness even though you might be very prone to having it. Great news!!

To recap: Genetics are largely modifiable. NOT your destiny. **Note, in a future post I’ll address genetic concerns such as the filaggrin protein and common SNPs (single nucleotide polymorphisms) that matter to eczema suffers.

Triggers are what provoke the signs and symptoms of illness. Those are along the lines of infections, allergens, toxins, radiation, surgery, social conditions, and things of that nature. They’re going to combine with the antecedents to actually cause more signs and symptoms.

Last, the mediators perpetuate the illness. You can think about these on a biochemical or psychosocial level. Biochemically speaking, the hormones, neurotransmitters, metabolites, free radicals, and inflammatory chemicals are what perpetuate what’s going on. Once you have that genetic factors, plus the triggers, these mediators keep that cycle going. In the case of eczema, it’s going to cause the flare to continue.

The psychosocial factors—stress, thoughts, beliefs, community- are extraordinarily important in this model, but also in eczema. Stress is often the primary trigger and tipping point for most people (***remember stress can be emotional or physiological like trauma or infection…regardless of the source, it causes systemic biochemical changes that are bad if they continue for a prolonged period of time).

Eczema ATM’s

Genetics, family history, lifestyle, past illness, and environmental exposures are key antecedents for everyone. For example, if you have certain historical factors like a family history of autoimmunity or allergies, asthma, and eczema (the allergic triad) you’re much more likely to get eczema than the rest of the population.

The most common triggers I see in practice are infections, allergens, toxins, diet, and dysbiosis (an imbalance in the microorganisms in your body—not just in your gut, but all over your body). In eczema, skin dysbiosis can be an important piece of the puzzle too.

Depleted Nutrients. In practice it’s usually omega 3 fatty acids, vitamin D, antioxidants such as vitamin C and selenium, and minerals such as zinc and magnesium. Protein malabsorption can be an issue too since you need the amino acids to make collagen and skin tissue.

Inflammatory chemicals. Histamine, cytokines, and free radicals are major contributors here, though there’s a long list of players in this biochemical pool.

Impaired liver function. If you’re liver can’t function optimally, you can’t clear metabolic waste, toxins or hormones efficiently which are essential for a healthy gut and skin. This is often one of the key places we address first.

Leaky gut. This occurs when many of the above factors cause increased intestinal permeability allowing things into the bloodstream (like bacteria, toxins, proteins, etc.) that shouldn’t be there. This causes inflammation and immune system activation driving the eczema cycle.

I find for most of the clients we see in our virtual clinic is that stress is often the most significant factor, either as a trigger or as something that’s perpetuating, or both. We work on addressing it in its many forms, in many different ways.

To recap- if you’re having an eczema flare or a flare-up of any autoimmune condition- you’re looking at: antecedents + the triggers + the mediators= cause of flare.

It’s a cyclical process that self-perpetuates until you identify the triggers and the root causes to stop this cycle. You must eliminate the root cause imbalances such as infections, hormone and nutrient imbalances, allergens, foods, etc., to get this cycle to stop. Then you actually need to take the proper steps to heal it (replacing nutrients, healing leaky gut, balancing hormones, improving liver function, etc.).

Real Life Eczema Example

I’m going to use myself as an example. I’m not necessarily proud of this, but we’re all human 😉

I was driving home from my sister’s this past Halloween. I had just thought to myself that I was so excited because I didn’t have any Halloween candy…. but then I did.

BAD IDEA!

About an hour later, it triggered a flare. And for me, the area where my eczema always, always, always starts is my left wrist and my left hand. They started itching like mad. I was scratching for four hours.

UGH!!!

Immediately, I went downstairs and took some anti-inflammatory nutrients because I knew I had to get at that flare before it became a full-blown outbreak. Yes, it is possible to dampen the effect of a flare once you have your eczema under control.

But for me, I had a major flare. My last major flare was 1.5- 2 years ago. I hadn’t had anything go on since then until I was pregnant recently and had a few minor flares (due to hormones) that went away quickly.

Let’s also review my ATM’s.

My major antecedent is the allergic triad in myself and family members. As I mentioned above, the allergic triad is allergies, asthma and eczema. Most of that manifests in childhood, but not always. I only had allergies in childhood. Eczema started in my 30’s! If you have any of those, you’re also going to be more prone to autoimmunity as an adult.

And, eczema often accompanies other autoimmune conditions, not just in and of itself.

So I have 2 of the allergic triad, and a family history of autoimmunity and inflammation conditions. There’s lots of cardiovascular disease and diabetes in my family. Historically, I was bottle fed and was around smokers growing up which are also key antecedents in developing eczema.

My main trigger for this flare was hormone imbalance and dysbiosis that developed during pregnancy. In the gut, when your hormones such as progesterone are high, it slows things down in pregnancy. It sets the stage for things like leaky gut and dysbiosis to occur. This was something that I had experienced quite a bit of during my pregnancy (even though I tried my hardest to prevent it since I know what I know!!).

Diet was also a key trigger (especially the candy). I kept a clean, organic diet for the most part. However, after the birth, my diet has not been quite as tight. I’m gluten-free and try to be in the realm of Paleo/Autoimmune Paleo. But sometimes I have corn or dairy or beans. And those things have crept into my diet more frequently now that I’ve had the baby.

The candy just happened to be the breaking point for me… that little bit put me over the edge!

My primary mediators were hormone and nutrient imbalances from pregnancy and breastfeeding, leaky gut, and STRESS.

I’m going to reiterate stress here… I’ve got a new baby. I’ve got a 5 year old. I’ve got work. I’ve got life. Everybody’s got stress. But I currently feel like I have a lot on my plate. That’s the main mediator perpetuating the cycle for me.

And for me, stress is probably the number one factor that contributes to my flares every single time. When my stress levels get high, I can get a flare super easily. And I know that’s true for many of the people we work with in the clinic as well.

Another less obvious mediator is lack of sleep. Lack of sleep is a major contributor to manifesting any autoimmune condition, especially something like eczema. We heal and regenerate when we sleep. If you’re not sleeping well, it’s not happening.

Lastly, there’s the issue of support and community, or a lack thereof. When you first have a baby, everyone comes and sees you for the first couple of weeks. And then it’s suddenly, it’s gone. This can leave you with a sense of feeling like you’re lacking community or lacking support. I won’t say that I feel that tremendously, but I feel it a little bit.

All of these things added up and resulted in my eczema flare.

I got it under control by tightening up my diet, doing some keysupplementation, andtopical salves. Thankfully, this prevented it from erupting into a full-blown outbreak.

Do you feel fatigued even after you get a full night of sleep? Do you have achy muscles and joints, brain fog, an inability to concentrate, or insomnia? Do you get rashes, eczema, hives, or skin irritation? Do you have a hard time tolerating cold or heat? Do you get diarrhea, bloating, constipation, or stomach pain?

If you answered “yes” to several of these, there’s a good chance you have an autoimmune condition. Many people suffer for years with a vague set of symptoms that look like many other conditions but can’t be clearly defined or put in a box. Today we know this previous gray area actually defines the symptoms that precede or are involved in the process of autoimmunity.

This inflammation-based condition is a hot topic receiving lots of press right now in the health world, especially in holistic functional medicine and natural medicine spaces. This is partially because some AI conditions are now easier to diagnose, but much is due to the fact that we now understand the role of the gut and root causes as mediators of autoimmunity, not just a breakdown of immune function. This is a message practitioners, patients, and researchers want to get out, as autoimmune diseases are so prevalent—they affect at least 50 million Americans.1

Until recently, it was standard thinking that AI couldn’t be reversed, but now we know differently. Identifying the root causes and reversing intestinal hyperpermeability (leaky gut) are at the core of reversing the autoimmune process in the body. Doing this, combined with some diet and lifestyle changes, could have you healing and feeling like an elevated version of yourself.

What Exactly is Autoimmunity?

Autoimmunity, at its core, occurs when the immune system attacks healthy tissues that it’s mistaken as a foreign invader.

Previously, science believed that it was purely immune dysfunction or an overactive immune system that caused autoimmune conditions. Knowledge has advanced now, and we know that there are lifestyle triggers that lie at the heart of immune system dysfunction. These triggers, combined with genetics and epigenetics (the environmental influence turning genes on or off) are what regulate the AI process.

This is only a short list of the conditions that have been described and categorized. In reality, you can have an autoimmune assault on any tissue in your body, and that process may not yet be defined, which can make diagnosis frustrating for you.

Even though there are many different types of AI conditions that are on a vast spectrum, they share one thing in common—that they’re all inflammatory in nature.

Chronic systemic inflammation sets the stage for an upregulated immune system that causes the body to attack itself.

The good news is that getting to the bottom of the root causes and making lifestyle changes can have a profound impact on the course of the autoimmune process, meaning that an AI disease doesn’t necessarily have to be defined to start reversing the process and healing.

How Does Autoimmunity Occur?

Dr. Amy Myers, MD, explains, “Autoimmune diseases are born when your body is working hard to defend itself against something potentially dangerous, such as an allergen, a toxin, an infection, or even a food, and it fails to differentiate between the intruder and parts of your own body. Mistaking certain types of tissues for harmful substances, your body turns these antibodies against itself, wreaking havoc on your organs.”1

The origin of autoimmune conditions is multifactorial and additive, in that it takes a genetically predisposed person in the right environmental circumstances with a leaky gut to develop an improper immune response. Family history accounts for one-third of the risk for developing an AI condition, as certain genes have been identified that directly affect the immune system and play a role in its hyperreactivity.14

Dr. Alessio Fasano, MD, the director of the Center for Celiac Research & Treatment at Massachusetts General Hospital for Children, has spent decades researching autoimmunity and how the immune system malfunctions, which led him to deduce that every autoimmune disease has three basic ingredients: a genetic predisposition, an environmental trigger, and a leaky gut.8,14

He explains that identifying the first two components was easy, since science has long known that AI conditions tend to run in families and that they can be triggered by infections, but the leaky gut component wasn’t identified until 2000, when he and his research team isolated the protein responsible for regulating gut barrier function, zonulin.14

Leaky gut, or increased intestinal permeability, arises when gut barrier function is compromised, allowing large particles that don’t normally enter the bloodstream to pass through. These particles are then triggers, causing the immune system to respond.

The environmental triggers are food sensitivities, allergens, toxins, and stress, which turn on the genes that initiate the AI process. This also generates chronic inflammation that perpetuates leaky gut and immune system activation.

Once the environmental triggers have entered the bloodstream, the immune system becomes primed and ready to defend, launching a biochemical war.

This war creates inflammation that activates certain genes, sustaining the immune response and allowing it to continue. As the war rages on and the immune system is on high alert, some confusion may arise, and the body may begin to attack itself.

One of the mechanisms believed to fool the immune system into thinking your body’s cells are pathogens is molecular mimicry. Molecular mimicry arises because there are specific protein sequences, or antigens, on the surface of certain microbial cells or foods that are similar to certain body cells such as the thyroid, intestinal cells, or nerves, essentially tricking the immune system. It loses its ability to clearly discern between self and non-self.

According to the ‘Thyroid Pharmacist’ Dr. Izabella Wentz, “This inadvertently causes a cross-reaction with our ‘self’ antigens, i.e., our own cells. This case of mistaken identity is thought to trigger the start of autoimmunity.”4

Similarly, another mechanism of autoimmunity occurs when toxins alter DNA and cause gene mutations. These mutations change the structure of tissues, causing the immune system to identify them as foreign and producing an assault on your body.

Triggers of Autoimmunity

The triggers that produce autoimmunity often occur together with the immune system responding to multiple ‘insults’ at the same time, since chronic inflammation mediates this process. Identifying the triggers and eliminating them is the key to reversing inflammation, calming the immune system, and shutting down the AI process. Common triggers of autoimmunity are:

Leaky gut

Dysbiosis and infection

Food sensitivity

Toxins

Stress

Trigger of Autoimmunity: Leaky Gut

Intestinal hyperpermeability, or leaky gut, starts when a trigger such as toxins, dysbiosis, stress, or food sensitivity creates inflammation, causing a dysfunction in zonulin, which regulates gut barrier function.

Fasano states, “Zonulin works like the traffic cop of our bodies’ tissues. It opens the spaces between cells, allowing some substances to pass through while keeping harmful substances out.” 6,8

Intestinal hyperpermeability occurs when there’s a breakdown in the function of zonulin, allowing larger particles such as bacteria, toxins, and partially-digested food particles through the intestinal walls to the bloodstream, where the immune system generates a reaction to clear them out. In genetically-susceptible individuals, these substances can eventually elicit an exaggerated or erroneous response, and the body can begin to assault its own tissue.

Leaky gut provides an easy access gateway to the immune system, when normally these particles would be kept out of the bloodstream. Under normal circumstances, when you encounter a typical foreign invader, such as a virus, bacteria, parasite, fungus (mold and yeast), or toxin, your immune system should answer by generating a response to anything it perceives to be a threat to your survival. In the case of autoimmunity, these large particles that have entered the bloodstream through a leaky gut cause an immune response that produces antibodies to the particles themselves and to the tissues of your body.

The causes of leaky gut must be eliminated and intestinal barrier function properly restored in order to reverse autoimmunity.

Trigger of Autoimmunity: Dysbiosis and Infection

Dysbiosis is the product of an imbalance between the beneficial and harmful organisms in your body, especially the gut. Healthy individuals have lots of the good guys within the GI tract that assist with digesting food, producing nutrients, and protecting from harmful organisms and inflammation.

When there’s a general imbalance between the good and bad flora, or when there’s an infection present, such as SIBO (small intestinal bacterial overgrowth), Candida (yeast), parasites, or mold, dysbiosis will arise. This imbalance allows for leaky gut to occur, since chronic inflammation develops as a byproduct, and it contributes to the deterioration of the intestinal barrier.

Native (commensal) and infectious organisms, like large particles leaked from the gut, can also trigger autoimmunity through molecular mimicry. Your body mounts an immune response, which is great when it zeroes in on a cold virus that shouldn’t be there, but it’s a problem when it mistakenly assaults your thyroid while it’s attacking H. pylori.4

There are many organisms implicated in the molecular mimicry process of autoimmunity, such as H. pylori (causes stomach ulcers and GI infections), Yersinia enterocolitica (causes GI infections), and Borrelia burgdorferi (causes Lyme disease), which may trigger Hashimoto’s thyroiditis.4

When the immune system sees Klebsiella pneumoniae, Shigella, Chlamydia trachomatis, and several other gram-negative bacteria, it ‘recognizes’ the self protein HLA B27 and attacks, inducing spondyloarthropathies, which are inflammatory conditions that include ankylosing spondylitis, psoriatic arthritis, and reactive arthritis (Reiter’s Syndrome).5 Viruses can also be triggers, as with multiple sclerosis and lupus, as well as the Epstein-Barr virus (EBV).5

If you have an AI condition, it’s worth investigating to see if you have dysbiosis or an infection that may be perpetuating the process.

Trigger of Autoimmunity: Food Sensitivities

Food sensitivities are very common in those with autoimmunity. The usual suspects are gluten, dairy, eggs, nuts, soy, and corn, although you can have a reaction to any food you eat, especially those you consume frequently. Lectins, which are proteins found in legumes and grains, also activate the immune system and are implicated in autoimmunity.

These sensitivities generally arise when the partially-digested food particles enter the bloodstream through a leaky gut. Additionally, under the right circumstances, a cross-reactive process may ensue as well.

In another case of mistaken identity, foods produce a cross-reactive response through the same antigen-antibody-mediated process that the microorganisms produce.

According to PhD scientist Sarah Ballantyne, aka The Paleo Mom, “For those 20% of us with Celiac disease or gluten-intolerance/sensitivity (whether diagnosed or not), it’s critical to understand the concept of gluten cross-reactivity. Essentially, when your body creates antibodies against gluten, those same antibodies also recognize proteins in other foods. When you eat those foods, even though they don’t contain gluten, your body reacts as though they do. You can do a fantastic job of remaining completely gluten-free but still suffer all of the symptoms of gluten consumption—because your body still thinks you’re eating gluten.”7

Gluten is one of the most sensitizing substances we consume, and eating the cross-reactive foods can be just as bad, since they elicit the same response. Common cross-reactive foods are rye, barley, spelt, Polish wheat, oats, buckwheat, millet, sorghum, amaranth, quinoa, corn, rice, potato, hemp, soy, teff, milk, chocolate, yeast, coffee, sesame, tapioca, and eggs.7

When you have an autoimmune condition, you’re best served by eliminating gluten completely and any cross-reactives that are triggers for you. There’s no middle ground here—it’s all or nothing, because even one little bite will provoke a potentially hazardous flare-up.

Trigger of Autoimmunity: Toxins

When it comes to autoimmunity, you need to be concerned with the toxins inside and outside the body.

Toxins are all around us in the air, water, soil, and our food supply. We’re exposed to astounding amounts of pollution. Over 80,000 chemicals have been introduced into our society since 1900, and only 550 have been tested for safety.9

Dr. Donna Nakazawa, MD and author of The Autoimmune Epidemic, calls these environmental toxins “autogens,” since they create a reaction against the self.9

The toxins we take in can alter our DNA, producing gene mutations that change tissues. The immune system can attack these tissues since they’re not identical to your healthy tissues. Furthermore, the toxins can alter gene expression by turning on genes that promote inflammation, which can then produce autoimmunity and leaky gut. These are some of the more common toxins:

The organisms that normally reside within us, as well as the pathogenic invaders, can also produce toxins. Mold produces mycotoxins. Bacteria have two toxic mechanisms—the excretion of toxins called exotoxins and the endotoxinson the cell membrane of gram-negative bacteria. These toxins activate the immune system and produce inflammation.

Trigger of Autoimmunity: Stress

Chronic stress has many negative impacts on health, especially with regard to autoimmunity.

Chronic stress produces constant activation of the sympathetic nervous system (fight or flight) and increases levels of the stress hormone cortisol. Over time, constant cortisol elevation leads to cortisol resistance, where the body has to produce more and more to achieve the same response. When this happens for prolonged periods of time, cortisol levels become chronically low, and adrenal fatigue develops. Cortisol is the primary anti-inflammatory hormone in your body, and when levels are chronically low, low-grade inflammation rages, paving the way for autoimmunity.

Additionally, chronic stress alters immune function over time, causing some aspects to be amplified and others to be diminished, producing dysregulation.

A 2009 study on autoimmunity revealed that “most interestingly, the release of endogenous glucocorticoids [cortisol] is critical in regulating the severity of disease activity in patients with inflammatory conditions such as rheumatoid arthritis (RA). Blocking of cortisol production results in a flare-up in disease activity in RA patients, while surgical removal of the adrenals in patients with Cushing’s disease has been reported to exacerbate autoimmune disease.” This clearly illustrates cortisol’s critical role in immune function and inflammation.10

Chronic stress produces physiological changes such as decreased blood flow, oxygenation, motility, enzyme output, and nutrient absorption that directly impact the intestinal flora and gut function.11 Since 70-80% of the immune system is within the gut, this means decreased gut and immune function, which can impact autoimmunity. Further, stress diminishes immunity by depleting the antibody secretory IgA (sIgA) as well as essential hormones, and it promotes inflammation, which can all result in a leaky gut.12

Symptoms of Autoimmunity

Autoimmune conditions are characterized by a myriad of symptoms that can be vague and varied, waxing and waning, making diagnosis difficult. Inflammation, being central in the AI process, is the root of many of these symptoms.

Once you’ve pursued these avenues, testing for specific conditionsmay be in order, such as TPA (thyroperoxidase antibody) and TGA (thyroglobulin antibody) for Hashimoto’s. Cyrex labs has several tests specifically designed for autoimmunity, food intolerances, and intestinal permeability. The Array 5: Multiple Autoimmune Reactivity Screen tests twenty-four different tissues for AI activity.13

Treatment of Autoimmunity

Treating autoimmunity can be easier than you think. Many people get some level of resolution with lifestyle changes and even further resolution when specific lab testing uncovers hidden infections, toxicity, or low cortisol levels that can be treated.

The easiest way to work your way through treatment is to take a systematic approach so you can more easily see what’s working and what isn’t.

Diet: This is the best place to start, since you’ll need some time to identify which foods you should be avoiding; making permanent dietary changes can yield massive benefits when it comes to autoimmunity.

The first step is to begin a 30-day elimination diet. You can make this basic and eliminate the usual suspects that trigger reactions like gluten, dairy, corn, soy, and nuts, but you’d be better off eliminating known AI triggers as well. These include seeds, eggs, legumes and grains (because of the lectins), and nightshades (all varieties of peppers, potatoes, eggplants, etc). You may even choose to stop eating gluten cross-reactive foods as well if you know you have issues with gluten. After 30 days, you can begin the re-introduction phase to see if you have any reaction to each food.

If you want to jump right into a diet change, Paleo can be a good place to start, since it naturally eliminates many of the AI triggers. The first study ever completed on autoimmunity and the Paleo diet was published in 2014 by Dr. Terry Wahls, MD and author of The Wahls Protocol. Although it was a small study, it illustrated the beneficial effects of adopting a Paleo diet in relation to AI disease—especially a reduction in fatigue.3,15

The Autoimmune Paleo diet takes it one step further and eliminates all food triggers of AI. Dr. Ballantyne has the Paleo Approach, and Dr. Datis Kharrazian both have versions of this that are great resources. Dr. Kharrazian’s AI diet focuses on gut healing and is a simple version that includes many meats, vegetables, fermented foods, coconut, certain herbs and spices, low glycemic fruit, and some condiments.16

With all of the diet information out there, knowing what to eat can be very confusing, but with some work you can do it. As with any diet, you need to tailor it to your own specific biochemical needs. This means that some of the foods on the “avoid” list might be okay for you, and some acceptable foods may not be.

You need to figure this out to optimize your diet and health. Find your “you” diet.

Nutrients and Supplements: There are so many different nutrients necessary for treating autoimmunity and inflammation. The following are some examples of anti-inflammatory and gut-healing nutrients you can start with:

Magnesium, vitamin D, and EPA/DHA (omega-3 fatty acids) are recommended by Sarah Ballantyne for their important anti-inflammatory and immune-modulating effects.3,17

Vitamins C and E, zinc, and selenium function as antioxidants and protect against oxidative stress.17

Glutathione is a critical nutrient, as it’s the master antioxidant in the body, and there’s a significant breakdown with its function in AI. Taking supplemental glutathione (or its precursor, NAC (n-acetyl cysteine)) with alpha lipoic acid (ALA) and glutamine will help recycle glutathione efficiently. ALA also functions as an antioxidant and supports healthy mitochondrial function. Glutamine is an essential nutrient for intestinal cells and helps repair leaky gut (along with glutathione).18

Reduce your stress levels: Stress is one of the main contributors to inflammation and poor immune function. Identify and manage your stressors. Reduce stress by creating boundaries, honoring your feelings, and organizing your life.

Relax: Take time-outs during the day to unplug and rest. Schedule downtime to give your body a rest by journaling, yoga, or meditation. Do what speaks to you.

Get into nature: Nature has significant healing benefits, so try to get out and enjoy it at least once per week.

Sleep: Getting adequate sleep is essential to healing. Avoid blue light stimulation from TVs, phones, and tablets for at least 2 hours before bed. Aim for a minimum of 8 to 9 hours per night, and try to get to bed by 10 PM. Sleep in a dark, cool, and quiet room for the most restful results.

Exercise: Moving your body is important to maintaining health and the healing process, but know your limits. Pushing too hard or too fast can delay your recovery. Give yourself adequate rest time, and only do what your body is telling you it can handle. In general, long-duration endurance exercises deplete cortisol and promote inflammation, so it may be best to avoid this and opt for walking, hiking, yoga, pilates, or weight lifting.

Empower yourself: Knowledge is power, so educating yourself on your condition makes you your best advocate. This knowledge will equip you with the best opportunity to manage your AI condition to give you the best quality of life.

Have you tried the drug store potions, over the counter (OTC) medications, or even prescriptions only to have little to no improvement in your eczema?

This is a common theme in my virtual clinic. We see many people that’ve tried everything, including things we recommend like diets or supplements, only to have a small change in their eczema. So, what’s going on??

The truth is that eczema, like any other chronic inflammatory or autoimmune condition, is complex and the causes are different for each person. This makes it difficult to treat, especially self-treat.

Super frustrating, right?

There’s a small percentage of people that can eliminate the common food triggers and take a couple of supplements, and achieve resolution of eczema. However, this is rare. If they don’t maintain their diet or have a major stressor, the eczema usually returns because they haven’t addressed the underlying causes.

You might be thinking- what do I do?

Addressing the root causes like stress, hormone imbalance, diet, gut infections, nutrient/vitamin deficiencies, and immune dysfunction provides long term resolution, but in the meantime here several natural eczema remedies to help control the symptoms and start healing.

Topicals

Don’t: Petroleum jelly goes under many names such a Vaseline®, petrolatum, mineral oil, or paraffin, and it’s a byproduct oil refining that contains compounds such ashydrocarbons that are harmful to health. It also seals the skin, trapping potentially harmful bacteria and letting the skin breathe.

Even worse, it can cause collagen breakdown which is the opposite of what you want if you have eczema.

Do: Shea butter, cocoa butter, coconut oil, and jojoba oil are all great options and each their own benefits. Some people find they work well alone, but in practice we’ve seen that people usually benefit from a combination.

You can purchase one like Moon Valley Organics EczaCalm(there are many other options available and we’ll be doing a review of our favorites so stay tuned). You can also customize a blend of your own with our Healing Salve recipe. The recipe can be altered with different base butters, oils and essential oils.

Remember, topicals help soothe the skin, but real healing comes from inside the body.

Supplements

Supplements seem to be an obvious starting place for natural eczema treatment, but in reality are a complex task to tackle, especially alone.

Don’t: Sadly, we see many people that are either on 20-30 supplements at once (YES…this is real unfortunately) and have no relief and lots of wasted money!!

The truth is this could be making the situation worse since you don’t know what ingredients are helping or hurting. Plus, there are the fillers, binders, and additives to consider as well as the active ingredients that could be causing issues.

Do: Start simply. Use single or few ingredient products that are clean, well sourced, and have a good reason for you to invest in them.

Here are two great options that have worked well in our clinic:

Collagen Proteinhas many benefits. It’s a critical building block of our skin that is compromised with eczemaand it helps heal the gut which is a primary root cause in eczema and other autoimmune conditions.

Bifidobacterium based probiotics reduce histamine and can help heal the gut. This 2008 study shows using B. infantis and B. longum reduced histamine signaling which can translate to less itching.

Diet

Again, diet is often difficult to navigate on your own (even harder than supplements). We’re all different and for some just taking out a couple of foods or food categories may work, but no one will ever respond to the same exact diet (not even identical twins).

Don’t: Taking on too many dietary changes at once can be overwhelming and lead to unnecessary (and unwanted) stress. Don’t try removing gluten, dairy, salicylates, and histaminesall at once. This will leave you with nothing to eat and likely cause confusion.

Do: Take baby steps with diet and monitor closely so you know what’s going on. An easy stepping stone is to remove all gluten or dairy products for 3-4 weeks minimum (you can do both if you’re willing). When you re-introduce them watch for reactions not only on your skin, but digestion, headaches, runny nose, fatigue, and achy muscles or joints.

Eggs, soy, corn, or nuts might be good options for you to test eventually too. If you find the main food allergens and sensitivities aren’t your problem, then it might be time to look at broad categories like salicylates or histamines.

The Bottom Line

These are all good, natural eczema remedies to start with and are things we recommend in the clinic while we’re working on reversing the root causes since the ultimate goal is healing on the inside and outside.

Is your life causing your eczema flares? Read on to find out if it is…

I believe it’s possible to teach old dogs new tricks. Yes, I’m referring to myself as an ‘old dog’ even though I’m not that old! However, it’s a fitting phrase to describe when I decided to retrain myself not to get stuck in the cycle of stress-eczema flare-clear skin-repeat.

My pattern was pretty obvious. I take good care of myself on every front except…drum roll…stress management. This is true for most of us, but this is a huge part of what I do to help heal people.

Yet, I wasn’t doing it for myself.

I was too focused on my job, side projects, and raising my son who was a baby at the time.

I dove into everything head first and never said no. I was all GO, GO, GO, 24/7.

Until my body would hit the wall from stress and I’d start get flare ups on my hands, wrists, forearms, stomach, and thighs. Tingling would turn into little red spots that itched so bad they’d spread out like an oil spill. Broken, inflamed skin would leave ugly patches.

I was especially embarrassed of my hands, wrists, and arms because people could see them. The palms of my hands and wrists were the worst unfortunately and people would sometimes look a little too long when I handed them payment, opened doors, or waved hello.

It’s amazing how many things our hands are involved in and how self conscious you can become once you’re aware that people are looking.

Gloves year round, anyone???

My usual approach was once I got sick of dealing with it, I’d really dial in my diet, take anti-inflammatory herbs, and engage in some stress reduction. That usually did the trick.

The itching would soon begin to subside, redness would retreat, and the bumps and patches would fade. After several weeks of being “good,” my skin would be clear again. AWESOME!!!

Then, I’d go back to my normal routine and inevitably have a flare up within a couple of months that was worse than the one before. It also started to get harder to treat.

Clearly I had a very short memory and I wasn’t learning from my past history!

Breaking the Cycle

After this cycle had been going on for over a year, I decided something need to change (there’s a longer version of this story that I’ll save for another day, but I’ll share the most important piece now).

The key change in retraining myself was managing my stressors. I needed to practice what I preached to my patients. Priority number one was establishing boundaries and stepping away from being a “yes” girl. I started to say “No” to many opportunities when I felt I had too much on my plate or felt I couldn’t give 100%. I also said “No” to social and family events if I was busy or starting to feel like I was being pulled in too many directions.

I also did a better job of decompressing and taking care of me, which meant giving myself breaks to exercise and have some quiet down time daily to do some deep breathing, journaling, or meditate (even if I had to sneak away to the “bathroom” to get it 😉). I also made consistent sleep a priority as much as I could with a nursing baby.

These are habits I’ve maintained to this day, except I don’t have to hide in the bathroom anymore for peace and quiet!

Stress management was the single biggest change I made to break the cycle, but I also developed strategies to tame a flare if I felt one coming on that I’m going to share with you.

7 Interventions to Stop Your Flare Before It Erupts

1. Clean your diet up. Most of us let our diet go when we’re under stress. Naturally, our bodies crave sugar and carbs to fuel our stress response (but we’re not running away from tigers and lions anymore). Sugar in general promotes inflammation, but so do gluten and dairy. I recommend eliminating these first if you haven’t already. Eating a diet focused on whole foods- meat, fish, eggs, veggies, fruits, and healthy fats will be supportive of calming inflammation.

If you’ve already pared down your diet, you might be sensitive to something else you’re eating. Start paying attention to how you flare responds to food. Do certain ones make you itch more? Do they give you other symptoms of inflammation like mucus production or joint pain? Is the response immediate or delayed?

Using a diary requires some effort, but it’s the best way to track the effects of diet and lifestyle. When I feel a flare come on, I open up an spreadsheet on my computer. I make columns for meals, immediate and delayed reactions, supplements, exercise, stress, sleep, and observations. I record everything that was notable and if nothing is notable I leave that spot blank. This way I can identify immediate issues, but also patterns that may otherwise be hard to see. This is actually how I figured out that I had a histamine issue.

2. Avoid Histamines. These nasty chemicals are produced in the inflammatory response and are part of the reason you itch. You can be consuming them in food or supplements like probiotics. There is a detailed list in my free triggers guide “Eczema: Seven Sneaky Sources Making Your Flare Worse.” Additionally, fish, seafood, cured and deli meats, aged cheeses, dried fruits, citrus fruits, pickles, and any fermented foods such as yogurt, kefir, kombucha, and sauerkraut. Basically, if it’s aged in any way- pickled, preserved, fermented, dried, salted or cured, it contains histamines. That makes left overs a no-go too.

Unfortunately, bone broth which is very healing, also contains high histamine levels, so watch out for any histamine related symptoms including itching, runny nose, mucus or phlegm, redness, etc.

Some strains of the probiotic group Lactobacillus (L. casei and L. bulgaricus) are known to produce histamine which may aggravate your eczema. From my clinical experience, I’ve also seen patients have a histamine reaction to other probiotics too, so pay attention to how your body responds to them. Remember- everyone is unique and we’ll all have different reactions to different substance.

3. Consume anti-inflammatory foods (or their supplement form). I’m a big fan of food as medicine. Some of the best anti-inflammatory foods are herbs and spices, specifically turmeric, ginger, and garlic. Together, these are pack a triple threat anti-inflammatory, antimicrobial, and gut and skin healing punch. They can be consumed easily in meals- especially any Asian or Indian recipes, added to smoothies, pre-made tea bags, or in this healing tea/infusion recipe.

The supplement forms can be used too. Sometimes you’ll find an anti-inflammatory combo with all or a few of these ingredients or they can be used separately. I prefer to use them for specific actions when using them as separate often highly concentrated supplements. In this capacity is use turmeric (curcumin) for inflammation, ginger for gut healing and calming, and garlic as an antimicrobial.

4. Avoid extreme temperatures. Whether you’re indoors or outdoors, or doing things like bathing or exercising, really hot or cold temperatures can have a negative effect on eczema. In the past, I’ve had a histamine reaction during exercise that resulted in extremely red and itchy legs in both summer and late fall. It’s really hard to workout when you stop to scratch every 10 seconds (plus people stare at your tomato red legs)!

Similarly, hot showers will do the same to me. I know when I’m in a flare to keep showers lukewarm or even cold.

5. Take a timeout. Not the kind where you sit in the corner and think about what you did wrong, but to similarly be still and contemplate. A couple of times each day take 10 minutes to just sit in silence while deep breathing. This doesn’t have to be a full on meditation (although if you want to- go for it because it’s amazing for stress reduction). The point is to let your mind quiet down and focus your intention to calmness and healing.

We spend all of our time in a stressed out, fight or flight mode (a.k.a. sympathetic nervous system ), which promotes inflammation, rather than the rest, digest, and reproduce mode (a.k.a. parasympathetic nervous system), which promotes healing. Chilling out, naps, eating, and sex are way more appealing anyway!

6. Laugh and play. Similar to the previous point, taking time to laugh and play does wonders for inflammation and counteracting the effects of the sympathetic nervous system. If you’re in a flare you might need to take a “personal day” from work.

Send the kids to school (if you have them) and just chill out watching funny movies or meet a comedic friend for lunch. When the kids come home, do something fun like playing games or something you all enjoy together. If you don’t have kids, grab a spouse, partner, or friend do your favorite activity.

The goal is enjoy life and put a smile on your face. There are lots of positive chemical effects that occur in your body when you smile, laugh, or share intimate moments with those you’re close with.

Bonus tip– if you’re a stay at home mom with a baby or small kids it’s hard to take a personal day. Instead of calling in sick to your boss, call a friend or family member to watch the kids for a couple hours (or more if possible) so you can focus on some fun or alone time. No running errands or chores- this time is for you to enjoy yourself!!

7. Pamper your skin with healing moisture. Once you get out of your not-too-hot shower, be sure to apply moisturizer ASAP. I’m a fan of my healing salve recipe, however, there are many options, especially if you’re just into the beginning of a flare. Coconut oil, shea butter, or a combination of the two may just be enough to get your skin going in the right direction. If you start to develop lesions, bumps, or extreme redness, the salve might be a better choice.

There are also many choices available online now too. I’ve had many clients tell me about creams and lotions that have worked for them. The key here is to get a clean and green one- avoid synthetic chemicals, dyes, and scents. Many of the good natural formulas have a base of coconut oil, shea butter, beeswax, and/or tallow (usually from beef) combined with essential oils or healing herbs. Going with a blend like this will help avoid topical reactions on the skin.

What remedies have you tried that have helped calm your symptoms down? Let us know in the comments section. Thanks!

Who doesn’t love their morning cup of caffeine? Coffee and tea consumption have become a significant part of American society. The cafe culture is a multi-billion dollar industry. This isn’t anything new…many civilizations for centuries have worshiped them too. But do these beloved brews contribute to eczema?

This is a question I’ve had to tackle for years in my practice with patients and for myself. Like any issues related to food or root causes of eczema- it’s a matter of individuality and how it’s affecting the inflammatory process in your body.

Personally, I love both tea and coffee for different reasons- I’ve been a lifelong tea drinker (thanks Grandma), but in my early 30’s I discovered coffee. I’d always loved the smell, but didn’t care for the taste. But as I began changing my diet to be cleaner and gravitated to Paleo/Primal, my taste buds changed.

Suddenly, I really liked coffee. I enjoyed the slight bitterness, dark chocolate, and fruity notes, much like a good wine. I hear this from patients too- they report liking bitter things such as coffee and really dark chocolate as they lose the taste for sugar.

I can drink it black, but I really love a warm cup of joe with grassfed butter and coconut oil in the morning. That’s heavenly for me!

So when the question of caffeine consumption and elimination arises, the reaction is similar for most of my patients- complete horror (even for a short duration). I’m often met with comments like: “there’s no way I can do that!” Or else, “you want me to do what!! And, for how long???”

I get it. The thought of giving up my tasty, warm beverages (especially considering that I live in Minnesota) gave me slight panic too.

Caffeine is America’s number one drug of choice. Some of us like it for the taste, mental boost, or the purely for the energy surge. But sadly, your favorite pick-me-up can be counterproductive if you have a condition like eczema that has roots in inflammation.

I don’t ask patients to drop the mug to torture them (although some may strongly disagree). I do it because I understand the many ways caffeine alters the immune and inflammatory response.

How do Coffee and Tea Cause Eczema

At first thought it may seem crazy to consider coffee and tea as causes of eczema, but they can alter the inflammatory response in ways that play a role in the process of developing eczema. Once you have eczema, they can contribute to the vicious cycle of exposures (foods, infections, toxins, etc.) that perpetuate the condition until they’re removed.

Here are the most significant ways that coffee and tea promote eczema:

1. It spikes adrenal hormones just as stress does. I generally suggest stopping if someone has HPA axis dysfunction (also know as adrenal fatigue) because of caffeine’s effects on the inflammatory process. Caffeine sends a signal to the brain which sends a signal to the adrenal glands to pump out cortisol and adrenaline (epinephrine), effectively putting your body in constant fight-or-flight mode. Not good if you have eczema and need your cortisol for its anti-inflammatory effects.

2. Elevated cortisol contributes to Leaky Gut. The chemicals secreted during the stress response are linked to intestinal permeability (leaky gut), inflammation, overgrowth in bad bacteria, and decreased microbial diversity that can alter immune function. These are significant root causes of eczema that need to be addressed to completely heal it.

3. You can react to the mycotoxins found in coffee. Mycotoxins are toxins produced by fungi and the 2 commonly found in coffee are ochratoxin A and aflatoxin B1. These compounds are known to be immunosuppressive, carcinogenic, and brain damaging among other health problems. Chronic, low level exposure can build up in your system causing an immune response that can promote inflammation.

Swap Your Caffeine with a Warm Drink That Will Help Heal Eczema

I hate to tell patients that they must avoid something forever. In some cases this is necessary, like a Celiac sufferer avoiding gluten, but generally, most people can handle some caffeinated beverages once they’ve healed their eczema and gut.

But until that joyous day when you can imbibe again, here’s an alternative that’s equally as tasty and will help heal your eczema and gut.

Eczema Healing Tea

I enjoy this drink because it’s reminiscent of my favorite morning coffee, but it also incorporates the spiciness of ginger and turmeric that I love. It’s also warming and soothing on cold days. Prep is quick and easy too- usually 5 minutes from start to finish.

Tip: If you want to have a speedy process, peel and portion out the turmeric, ginger, and garlic for several days. I keep mine in a mini mason jar or glass container in the refrigerator. If you prep too much it can start to dry out, so placing a small damp towel or cloth on top can help prevent that.

Instructions

1. Get your water heating up before you start prepping so that you can pull if off and let it cool if necessary before you pour it into the mixture. I like to use a kettle to warm mine up.
2. Remove the skin from you turmeric, ginger and garlic. You can use a knife or spoon (scraping down the sides) to get rid of the skin. Note: spoon scraping gives a slightly better yield but is more time consuming than using a knife. Place them in the blender.
3. Add in the coconut oil and honey.
4. Pour the water over the mixture. Warning: don’t blend it up if it’s too hot and steaming because the pressure could build up and burn you when the lid is removed.
5. Add the collagen in last (truthfully, it probably doesn’t matter when it’s added, but I try to keep the collagen from clumping or sticking to the sides of the blender cup or carafe).
6. Blend up until all ingredients are fully incorporated. It should take 15-30 seconds for most high speed blenders.
7. Pour into a mug and enjoy!

The beauty of this recipe is that it can be adjusted to taste and needs. Don’t like turmeric- don’t add it. Have a sensitivity to collagen powder? Leave it out. Got Candida or a fungal issue? You may want to adjust or eliminate the raw honey. You can customize this as you wish.

I actually make variations on this recipe often. I’m a ginger lover so I’ll add a huge 3-4 inch piece in sometimes. I’ll bump up the collagen if I feel more stressed. I don’t always have raw turmeric on hand, so I make it without it. If I’m feeling congested or sick from a cold, I’ll decrease the water by 2-4 ounces and add in the juice of one lemon and/or raw apple cider vinegar (ACV). Be careful using this variation if you’re in an eczema flare as the histamines in lemon and ACV can make symptoms worse.

Eczema Healing Tea is a Healing Bomb and Inflammation Buster

The elixir is packed with several anti-inflammatory, immune boosting, antimicrobial, and skin supporting ingredients. Coffee and tea definitely can’t claim that. Here’s a breakdown of the benefits:

1. Turmeric is a member of the ginger family which is why they share similar characteristics. However, the curcuminoids are what give turmeric it’s superior inflammation fighting power. The journal Oncogene published a study that found turmeric to be one of the most potent anti-inflammatories in the world, even beating out NSAIDs. It can also help heal the lining of the intestines which is critical for resolving eczema.

2. Ginger, like turmeric, supports immune and anti-inflammatory pathways in the body. Ginger is a great antimicrobial too, acting against a wide range of bacteria and fungi like Candida. It’s widely supports the gut too- relieving nausea, bloating, constipation, and acid reflux which are symptoms that often accompany eczema root causes like dysbiosis, GI infections, and food sensitivities.

3. Coconut oil is considered to be the “motherlode” of healing foods. One of best features is the broad antimicrobial activity of lauric acid- helpful for addressing bacterial, fungal, and viral infection, but also maintaining daily health. The antioxidants in coconut oil are well documented to combat inflammation. It also has pain relieving (analgesic) capabilities. The same properties that make it amazing for internal use also apply to the skin. Externally it can be used as a cleanser, moisturizer, and as an ingredient in a healing salve or ointment.

4. Garlic in its raw form is a close second to coconut oil in it’s ability to protect against the “bad bugs,” having potent antibacterial, antiviral, and antifungal properties. The sulfur containing compound allicin is effective against the opportunistic staphylococcus (staph) bacteria which is thought to play a role in eczema for many individuals. Personal note- when I did stool testing on myself during the peak of my symptoms I had a slight overgrowth of staph that had to be treated.

5. Raw honey is an antioxidant powerhouse. It contains several classes of polyphenols and flavonoids that support the immune system. In addition, it contains 22 amino acids, many of the B complex vitamins, and 27 minerals including magnesium, potassium, iron, zinc, selenium, calcium, and phosphorous.

6. Collagen is the most abundant protein in the body and a critical building block of the skin. Using supplemental collagen powder has been shown to improve skin quality by increasing the barrier function meaning better elasticity, moisture, and texture. Good news if your skin is damaged from eczema! Another reason collagen is great is that it heals leaky gut, which is a primary root cause in eczema. It’s benefits are similar to what’s seen on the skin externally- it “seals and heals” the intestinal barrier breakdown that’s the hallmark of leaky gut.

Doesn’t all this goodness make you want to brew up a batch right now?? You may not ever want to go back to coffee or tea! Maybe….. 🙂

I’ve always been a questioner. This is why I believe eczema can be healed and reversed (and new science backs this). When I was a little kid, I asked lots of questions because I wanted to know how and why things worked. Conversations I’d frequently have with my parents would go something like this:

Me: “Why does my tummy hurt?””

Parent: “Probably because you just swallowed your gum.”

Me: “Why would gum make my tummy hurt?”

Parent: “When you swallow your gum it can stick to your insides.”

Me: “Why would it stick to my insides?”

Parent (frustrated): “Oh, I don’t know, it just does!”

At this point I usually stopped the dialogue because I was clearly annoying my parents and I was frustrated that I didn’t get the answers I desired. Even as little kid I couldn’t understand why gum wouldn’t be digested like the rest of my food?? It also didn’t make sense to me that it would stick to my insides. There is always a reason why (even if not everyone know the answer).

Those same feelings of frustration and disbelief came to the surface for me when I was told I had Eczema. I was instantly transported back to my childhood when I heard the words “there is no known cause or cure.” It was so infuriating and disheartening.

No cause. No cure. Yet, you’re still miserable, with a very real rash that makes you crazy because you want to keep scratching it incessantly and your doctor hasn’t provided you with any help at all. This is exactly how I felt.

The majority of conventional medicine still clings to the old idea that eczema, also known as atopic dermatitis, is purely a topical rash that makes your skin red and itchy, causes lesions, and is related to allergies.

And if you’ve ever had an eczema breakout you know that this isn’t just something to brush off, or something you should have to live with- it’s a problem that affects the way you look and feel too.

I’ve never accepted the no cause, no cure paradigm- there’s always a reason why something is happening. Your body just doesn’t start to malfunction- it’s way too smart for that. There are complex physiological processes that occur over time that culminate in conditions like eczema. We’ll get into the details of that later.

Those of us in the functional medicine community, as well as many researchers, are redefining what eczema actually is. In December 2014, this groundbreaking study published in The Journal of Allergy and Clinical Immunology confirmed what many of us suspected all along- that eczema is indeed an autoimmune condition. The study showed that by blocking 2 key proteins involved in the body’s ability to fight off bacteria and viruses, the eczema was reversed. In the process of eczema, these proteins mistakenly target the body’s own tissues, causing an autoimmune reaction which can result in the body attacking the skin. That sounds like a cause to me!

But before we get into the details of how eczema develops as as autoimmune (AI) condition, let’s review what eczema is and briefly discuss the types.

What is Eczema?

As an inquisitive and frustrated kid, I’d reach for the encyclopedia when I got one of those “it just is” answers from an adult. Encyclopedias helped, but were still limited in information on many topics.

Now we have an overabundance of information coming at us 24/7 thanks to the internet, but it’s hard to digest and make sense of it all. So, let’s break eczema down.

Eczema is more commonly referred to as Atopic Dermatitis (AD) clinically. That term is very telling since atopy or atopic is Greek for “being out of place” and dermatitis is “inflammation of the skin”. What’s interesting is that in my graduate training (which was conventional medical clinical pathology) we learned that atopy refers to an allergic reaction or hypersensitivity occurring in a part of the body NOT in contact with the allergen. Based on this definition you’d think that conventional medicine would’ve realized the cause of eczema isn’t occurring on the skin level, but that hasn’t been the case.

Eczema or Atopic Dermatitis (AD) is defined by the Mayo Clinic as “a condition that makes your skin red and itchy. AD is long lasting (chronic) and tends to flare periodically and then subside.” It’s the most common type of eczema and research suggests that a family history of atopic conditions such as eczema, allergies, asthma, and hay fever is a predisposing factor in developing it. The data compiled from my research analyzing over 7,000 patients shows that 1 in 5 people with a family history of eczema have eczema. 20% is significant.

Typical symptoms include:

Itching, which may be mild to severe, especially at night

Raw, sensitive, swollen skin from scratching

Small, raised bumps, which may leak fluid and crust over when scratched

Weeping wounds

Thickened, cracked, dry, scaly skin

Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees

Eczema symptoms and appearance differs from person to person. A mild form might look like red, irritated, and slightly speckled skin, to more severe forms where the skin is significantly inflamed, with lesions that are bloody and weeping. Discolorations often occur during the outbreaks and as the skin heals.

7 Types of Eczema (Yes, …there’s actually more than one)

There are many different types of eczema according to various sources. You could go a little crazy researching them all on Dr. Google, so we’ll cover the most common ones here.

Most varieties of eczema are named for where they occur or because they look slightly different than your typical atopic dermatitis. Regardless of where it located or how it looks, it’s still eczema.

Contact Dermatitis occurs when an irritant or allergen contacts the skin causing redness, burning, swelling and sometimes blisters. It can be caused by things such as frequent hand washing, solvents, chemicals, foods, metals, animals, pollen, and plants like poison ivy. For the record, I don’t believe contact dermatitis should be classified with these other forms of eczema as the cause is external contact and can happen to anyone regardless of health conditions and family history. It doesn’t appear to be AI in nature.

Dishydrotic Eczema occurs on the palm side of fingers, palms of hands, bottom of toes, and soles of feet. It presents as red spots, bumps, or blisters. Scaly patches, flaking, and deep cracks can form from damage to the skin. This type is 2 times more common in women. I can vouch for that since this one type that I had in a very classic presentation which makes it easier to distinguish from some of the other types.

Hand Eczema is different from dishydrotic in that it occurs on the back of your hand and fingers, as well as the webbing between fingers. It visually looks more like typical atopic dermatitis.

Neurodermatitis, also called Lichen Simplex Chronicus, which is similar to AD in that there’s significant itching but differs in that the surrounding skin is healthy. It occurs in isolated patches that look thick, discolored, dry, scaly or flaky and can be mistaken for psoriasis. There can be underlying dysfunction of the nerves in this area.

Nummular Eczema, also known as Discoid Eczema is characterized by coin or circular shaped lesions that can be raised. Inflammatory reactions occurring in the body and dry skin are thought to play roles in developing this type of eczema. It can look like ringworm which is a fungal infection so it’s worth ruling that out.

Seborrheic Dermatitis, Scalp Eczema, or Cradle Cap typically occurs in areas where there are high concentrations of oil producing sweat glands including the scalp, face, neck, upper back, shoulders, and chest. Individuals with immune system dysfunction are at increased risk for seborrheic dermatitis. It can have an oily or greasy appearance, unlike the other types of eczema, with white to yellow flakes.

Stasis Eczema/Dermatitis, also called venous stasis dermatitis, is a special type of eczema that occurs in areas where there’s decreased venous blood flow resulting in pressure build up causing fluid leakage from veins. Red, swollen, flaky, itchy skin occurs initially and if not taken care of can progress to ulceration, infection, and/or permanent thickening or scarring of the skin.

What Causes Eczema

If you type in ‘causes of eczema’ in Google, you’ll get a variety of answers like:

Unfortunately, while many of the above are absolutely true, most conventional doctors still treat it like it’s a condition that only occurs on the surface and don’t address most of that list. They’re likely to suggest topical treatments and possibly tell you to avoid a couple of foods, allergens, and hot or cold weather. They neglect the impact of the true root causes beneath the surface.

The worst fact of all is that some doctors are still of the old school thinking that there is no cause or cure for eczema.

Thankfully, research is evolving and know we know otherwise.

Given that eczema is now considered an autoimmune condition, we know the conditions need to be ‘just right’ for one to manifest.

These are the 3 key factors that come together to initiate autoimmunity:

A genetic predisposition/family history

Intestinal permeability (leaky gut)

Environmental triggers such as stress, infection, gut or skin dysbiosis (imbalance between the good and bad bugs), food sensitivities or allergies, trauma, hormone imbalances, toxins, and nutrient imbalances.

With autoimmunity, the immune system mistakenly targets a body tissue and tries to attack it like it’s a foreign invader. If you have eczema, this means that the autoimmune process is attacking your skin. And to get rid of eczema, you need to address each of your root causes, which are covered in numbers 2 and 3 above.

For me, the perfect storm for eczema flares was high stress levels, hormone imbalances, GI infections and dysbiosis, leaky gut, and food sensitivities. Histamine containing foods, exercise, and hot showers made it even worse. This scenario is very similar for most of my clients as well.

A New Paradigm for Eczema

Just like when I was a kid, I wasn’t satisfied with the explanation of what causes eczema, so I developed my own process to explain the cycle of how it occurs.

Stage 1: Flare Up

You know when a flare up is coming because your body send you little signals in the form of tingle, slight itchiness or a burning sensation. On the inside the panic begins to set in and you’re thinking, “Oh no, not again!” These are the subtle hints that you’re body is unhappy and it’s trying to tell you. The flames have been stoked and a fire is beginning to burn inside.

From a physiological standpoint, your immune system is activated from one or more triggers like foods, chemicals, toxins, or microorganisms (bacteria, fungi, parasites, viruses) and has begun attacking your body tissues. Having a genetic predisposition toward eczema or autoimmunity, and a leaky gut make this the perfect storm.

At this point, trying to stop or slow the flare is a good idea as it will help begin to reverse the inflammatory process. Start with your diet as many significant triggers for eczema are food related. At a minimum go gluten and dairy free, but likely you’ll find other foods that need to be avoided while you heal.

Getting stress under control right now is key as it’s often what pushes you over the edge into a flare. It’s hard to eliminate it, but try to manage stressors by maintaining boundaries, saying no, or asking for help. If you can completely eliminate a stressor (like avoiding a toxic person or situation) even better! Also, finding an outlet like journaling, deep breathing, meditation, or walks in nature can profoundly reduce the stress response.

Stage 2: Outbreak

Your flare up transitions to a full blown outbreak when the tingle, burn or minor itch escalates to constant itching causing red, inflamed skin with welts, wounds, and/or blisters. At this point it can appear to be treatment resistant since all of the root causes likely haven’t been addressed.

The outbreak occurs when the inflammatory process mediated by the immune system goes unchecked. The inflammatory chemicals have kicked up and are peaking resulting in your extreme discomfort and many symptoms. During this phase eczema can interfere with life, making social gatherings, work, sleep, and sanity difficult due to the incessant itching. There’s a full blown inflammatory fire raging inside.

Getting to the bottom of all of your triggers and root causes is essential now so you can heal. Addressing diet and stress may do the trick for some, but others may require deeper digging or testing which is easiest with assistance of a trained professional. Even though I do this for a living, I call upon my friends and colleagues to make sure I’m not missing anything. We can all use some help now and then!

If you haven’t begun dialing in your diet- there isn’t a better time. You need to focus on taming the fire burning within. Anti-inflammatory supplements and foods are super important now. This blog article I wrote provides a recipe, as well as 6 healing foods and supplements to help put out the flames.

Topically, some people may benefit simply from coconut oil, but I personally didn’t and many of my patients echo that sentiment. The same can be said of shea butter. However, by combining these an easy and wonderful healing salve can be made.

Eczema Healing Salve Recipe

½ cup unrefined, organic coconut oil

½ cup unrefined, organic shea butter

10 drops calendula essential oil

10 drops yarrow essential oil

10 drops rosemary essential oil

5-10 drops frankincense essential oil

Mix these together in a bowl by hand or with a mixer. It will be hard and clumpy at first, but eventually will soften and everything will come together. Note: you can play with the essential oils as some people respond better to certain ones than others. If you can’t some of these, that’s fine too. These all have healing, calming or anti-inflammatory properties.

The most important thing to remember in the outbreak phase is the root causes. If you don’t identify and address them all, your eczema is likely to return at some point.

Stage 3: Healing

Relief is in sight! This is when you start to feel better and symptoms are less severe, but still present. You may or may not be itchy. Your skin still shows signs of irritation, but no open wounds and blisters. It may also appear thick, leathery, scaly, dark, or ashy now. The fire within is now just smoldering embers.

Your immune system is now ramping down and under control, but in physiological time things go slow which is why there are still visible signs (think of how long it takes to completely heal a cut or broken bone).

Steering clear of dietary triggers or any other triggers you’ve identified through self investigation or testing is still a must to maintain healing. Continue use of natural topicals to protect the skin and help rebuild integrity. Nutrients like vitamins A,C, D, and E, biotin, zinc, selenium, and collagen support healing and skin structure.

Stage 4: Clear Skin

Hooray!! When you’re suffering through an eczema flare you often don’t think this day will come, but it is possible to completely reverse eczema and have clear skin again. You’re skin is fully healed and looks great again. No more hiding in long sleeves or gloves!

Think of this stage as maintenance or dormancy. You immune system is finally calmed down and balanced so the attack on skin is over. The fire is out completely!

Maintaining a healthy diet, stress levels, and getting adequate sleep will help keep you here in your happy place.

Common Treatments for Eczema

Again, if you look eczema treatments up in Google, you’ll get a list that looks like this:

While the medications may be helpful at first for managing symptoms, they don’t address the root causes and the eczema returns. Long term, the topical creams can damage the integrity of the skin and the topical steroids and oral medications shut off the body’s natural inflammatory response which is counterproductive to healing the body.

The moisturizers typically suggested sometimes work and other times cause more irritation due to the ingredients. Unfortunately, if they do work it’s only addressing issues at the skin level and not what’s beneath the surface.

Special baths can definitely be helpful in managing symptoms, but some need to be use with caution. I am personally not a fan of the bleach baths, ever. Sea salt, table salt and apple cider vinegar can be great, however should be tested first since they could irritate open wounds. Oatmeal baths are also very soothing as long as you know you don’t have Celiac or it’s skin variant called Dermatitis Herpetiformis. If you do, you should probably avoid oatmeal completely as it’s often contaminated with gluten.

Phototherapy from the sun is my preferred use. While using phototherapy lamps that emit UV light definitely have benefit, there are a few more risks associated with them due to broader spectrum of the light rays, such a burning, blistering, accelerated aging/breakdown of the skin, and skin cancer. More recently narrow band UVB therapy, which uses a smaller spectrum and thus less radiation, is a better option for artificial light therapy.

Wet dressings can be very helpful in healing eczema when used with natural moisturizers. However, topical corticosteroids are often used and I believe they’re a bad long term strategy for the reasons given above.

My Methodology for Healing Eczema

While some of the commonly used treatments listed above can be helpful at soothing or even resolving some symptoms, they’re all missing the most important factor: addressing the ROOT CAUSES.

Even if you’re in remission and asymptomatic, you’re still at risk for a flare up because you haven’t addressed the important factors lingering beneath the surface. You’re trigger might be work, family, or financial stress, a stomach virus or infection, passing of a loved one or pet, a divorce or separation, moving to a new town or job, or even injuring yourself exercising.

My major trigger was always work related stress (or not addressing it) as it is for so many that suffer from eczema.

The good news is that I healed my eczema and we, together, can heal yours too.

My process starts with a detailed history, from birth until now, that identifies all of the contributing factors to your eczema and what potential root causes need to be investigated.

Next we order the appropriate tests to identify your specific and individual underlying causes.

From there, I design a comprehensive program based on your results and history that addresses all of your root causes in a systematic way. We don’t throw the kitchen sink at you all at once and hope it works. Instead, the plan is outlined in a step-by-step manner that makes it easy for you to follow and allows your body to heal.

If you’re tired of living in the eczema cycle of remissions and flare ups, or have an active, raging outbreak that itches so bad and looks so horrible it’s affecting every aspect of your life and you don’t think it will ever end, I invite you to work with me and my team to heal your eczema for good.

We’ll work together to put the pieces of your health puzzle in place. We’ll guide you at every step with a plan of action to get your body healing and skin happy again.